https://www.um.edu.mt/library/oar/handle/123456789/10089 Mon, 20 Apr 2026 09:23:26 GMT 2026-04-20T09:23:26Z https://www.um.edu.mt/library/oar/handle/123456789/9994 Title: An assessment of knowledge and self-care practices in patients living with type 2 diabetes mellitus Abstract: Background: Type 2 diabetes mellitus is a progressive and chronic disease associated with reduced quality of life, premature mortality and substantial economic costs. Self-management in persons living with diabetes is vital since these individuals, together with their families, provide 95% of the overall care of their condition. Aim: To determine whether there is an association between the level of diabetes-related knowledge and diabetes self-care practices in people living with type 2 diabetes in Malta. Design & Methods: A multi-centre, non-experimental prospective study design was conducted on 50 Maltese patients living with type 2 diabetes mellitus attending the primary healthcare setting. The participants had to be over the age of 18; living with type 2 diabetes; primarily responsible for their own care; capable of comprehending the English or Maltese language and mentally and physically fit to participate in the study. The DKQ-24 and SDSCA questionnaires were used to assess diabetes knowledge and diabetes self-management respectively. Results: The mean diabetes knowledge score was 14.40 out of a total of 24 and the mean self-care activities score was 2.89 out of a total of 7, indicating a deficit in a number of key areas in the management of diabetes. There was no statistically significant correlation between diabetes knowledge score and diabetes self-care activities (r = 0.190, p = 0.187). On analysis of the individual sub-scales a significant relationship resulted between diabetes knowledge score and diet (r = 0.324, p = 0.022) but physical activity (r = 0.179, p = 0.214), blood sugar testing (r = 0.231, p = 0.107) and foot care (r = 0.189, p = 0.189) gave no significant results. On further analysis, education level was significantly correlated to diabetes knowledge score (r = 0.374, p = 0.007) and self-care activities score (r = 0.317, p = 0.025) while age was significantly correlated to diabetes knowledge score (r = -0.373, p = 0.008) and self-care activities score (r = -0.299, p = 0.035). Conclusion: The study has highlighted knowledge deficits and inadequate levels of adherence to certain areas of self-care in the study group. This study further confirms the inconsistent relationship between diabetes knowledge and self-care. Therefore integrating theories of behavioural change into educational interventions, including psychosocial concepts such as patient-centred care, self-efficacy and empowerment, may assist in strengthening the relationship between diabetic education and self-management in type 2 diabetic patients. The need of encouraging self-care practices and educating people about the cause of disease and its complications could translate into improved care and quality of life. Description: B.SC.(HONS)PODIATRY Wed, 01 Jan 2014 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/9994 2014-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/9992 Title: The effect of the kinetic wedge on Hallux dorsiflexion in patients with functional Hallux limitus and severely pronated feet Abstract: Background: Functional Hallux Limitus is a condition in which there is adequate dorsiflexion of the first metatarsophalangeal joint in nonweightbearing conditions, but with limited dorsiflexion of the first metatarsophalangeal joint during gait. This can be due to the first metatarsal being unable to plantarflex adequately during gait, due to tension in the plantar fascia (caused by excessive pronation) creating a plantarflexion moment on the proximal phalanx of the hallux, or due to the inefficiency of the peroneus longus muscle to stabilize the first ray. The kinetic wedge is an adaptation designed by Dananberg which involved the use of a cut out under the first metatarsal head, this allows the first ray to plantarflex more freely. Dananberg claims that the kinetic wedge increases dorsiflexion at the first metatarsophalangeal joint Aim & Objectives: The aim of the study was to assess whether the kinetic wedge affects first metatarsophalangeal joint dorsiflexion in feet with severe pronation and Functional Hallux Limitus. The objectives included measuring first metatarsophalangeal joint dorsiflexion with the use of three-dimensional motion analysis, and assessing if there was a difference in first metatarsophalangeal dorsiflexion with or without the kinetic wedge. Design & Methods: To evaluate the effect of the kinetic wedge on first metatarsophalangeal joint dorsiflexion a quantitative, quasi-experimental, one-group pretest-postest design study was employed. A group of participants (n=12), of average age 22 (Range 19-28), with a foot posture index score of greater than +10 and a positive Hubscher manoeuvre, but otherwise healthy individuals were chosen. A number of static and dynamic measurements were recorded using a three-dimensional optoelectronic motion analysis system. Measurements were taken in three different settings: barefoot, shoe intervention (which involved the shoe with the Vasyli Howard Dananberg orthoses, without the kinetic wedge) and kinetic intervention (which involved the shoe with the Vasyli Howard Dananberg orthoses with the kinetic wedge). First metatarsophalangeal joint dorsiflexion was calculated by subtracting the static angle from the dynamic angle for each respective setting. Results: No significant difference in first metatarsophalangeal joint dorsiflexion was noticed when comparing the shoe intervention to the kinetic intervention indicating that the kinetic wedge did not significantly affect hallux dorsiflexion (P= 0.075). However, first metatarsophalangeal dorsiflexion was significantly higher in the barefoot setting when compared to the shoe and kinetic interventions (P= 0.000). Conclusion: The kinetic wedge did not have a significant effect on first metatarsophalangeal joint dorsiflexion. Even though the shoe was flexible, there was still a significant decrease in first metatarsophalangeal dorsiflexion in the shoe intervention when compared to the barefoot walking. There is need for further research regarding the effect of orthoses and footwear on first metatarsophalangeal joint dorsiflexion and the incidence of structural hallux limitus in relation to foot posture and Functional Hallux Limitus. Description: B.SC.(HONS)PODIATRY Wed, 01 Jan 2014 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/9992 2014-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/9950 Title: The effectiveness of negative pressure wound therapy using vacuum-assisted closure vs calcium alginate dressings in the treatment of arterial diabetic foot ulcer Abstract: Background: The prevalence of chronic, non-communicable diseases such as diabetes mellitus are very common (12% prevalence in Malta). One of the major complications of diabetes mellitus (4-10% of this population) is foot ulceration. Such complications take up 10% of the total health care budget. Different local wound procedures to manage foot ulcers exist including various dressings but little consensus exists on which dressing, antiseptic agent or therapy would be the ideal choice. The choice of dressing depends on a plethora of wound factors; the amount and type of drainage, size, depth, type of ulcer and the condition of the surrounding skin Aim: The aim of this study was to analyse the effectiveness of negative pressure wound therapy using vacuum-assisted closure versus calcium alginate dressings in the treatment of arterial diabetic foot ulcers. Research design and method: A single-centre quasi-experimental, matched subject clinical trial was conducted at the Tissue Viability Unit. Thirty patients living with type 2 diabetes and presenting with a newly diagnosed arterial foot ulcer were recruited. Subjects were divided into 2 groups. Group A (n=15) underwent negative pressure wound therapy and Group B (n=15) underwent calcium alginate dressing treatment. Patients were assessed in the clinic and there ulcers were measured for their surface area and depth. Following application of treatment, the patients were reviewed every 3/4 days and assessed accordingly. Ulcers were measured at the end of treatment to assess the change. Results: Both negative pressure therapy and calcium alginate dressings were effective in reducing the surface area and depth of ulcers (p=0.00). However, negative pressure was 3.2 times more effective in reducing surface area of the ulcer and 3.78 times in reducing ulcers depth when compared to calcium alginate (p=0.000) Conclusion: Negative pressure wound therapy by the vacum-assisted closure therapy system could be considered as an effective treatment for complex arterial diabetic foot ulcers and is more effective than calcium alginate dressings. Improved care could result in improved quality of life to all those living with type 2 diabetes, improved health outcomes, lesser diabetes related complications and less expenditure from the Maltese health care budget. Description: B.SC.(HONS)PODIATRY Wed, 01 Jan 2014 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/9950 2014-01-01T00:00:00Z